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Learn why treatment after opioid overdose matters, including rapid MAT evaluation, naloxone, counseling, family safety planning, and continued recovery support.
New Hope Health
Editorial Team
A suspected opioid overdose can turn into a medical emergency within minutes, especially with fentanyl, fentanyl analogues, and other synthetic opioids. Opioid toxicity can cause opioid-induced respiratory depression because opioids affect brain systems that control breathing, while severe cases can lead to cardiac arrest or death. As the opioid crisis continues to drive drug overdose deaths, Knoxville families may have questions about opioid overdose signs, emergency care, naloxone administration, and what happens after overdose reversal.
An opioid overdose occurs when opioids slow breathing to a dangerous level, which can reduce oxygen reaching the brain and other vital organs. Signs may include slow or stopped breathing, loss of consciousness, pinpoint pupils, choking or gurgling sounds, and blue or gray lips or skin. Naloxone can rapidly reverse an opioid overdose, but emergency medical care is still necessary because its effects may wear off while opioids remain in the body.
After the immediate crisis, medical providers can evaluate the person for complications and signs of opioid use disorder. Follow-up addiction treatment can address continued opioid use, overdose risk, withdrawal, mental health concerns, and steps that may reduce the risk of another overdose.
A previous opioid overdose increases the risk of another overdose. Illegally made fentanyl raises this risk because it is highly potent and may be present in counterfeit pills or other drugs without a person knowing. Reduced tolerance after detox, incarceration, hospitalization, or a period without opioids can also make a previously used dose dangerous.
Mixing opioids with alcohol, benzodiazepines, or other sedating substances can further increase overdose risk. High opioid doses, continued substance use, and returning to opioid use after losing tolerance are also major risk factors. Fentanyl is 50–100 times more potent than morphine, while overdose risk is also higher with older age, male sex, and low socioeconomic status; after reversal, patients may be monitored for several hours and provided naloxone kits before discharge.
Surviving an opioid overdose does not remove the underlying risks associated with opioid use disorder. Without continued care, a person may return to opioid use and remain vulnerable to another overdose, especially if tolerance has decreased or fentanyl is present. An overdose can serve as an important point for connecting a person with addiction treatment.
Treatment can address opioid cravings, withdrawal, continued drug use, mental health symptoms, and behaviors that increase overdose risk. Care may include medication-assisted treatment, counseling, naloxone access, family education, and relapse prevention. Continued treatment can help patients build stability while reducing the risks associated with ongoing opioid use.
A medical provider can evaluate a person for medication-assisted treatment, also called medications for opioid use disorder, after an overdose. The appropriate medication and timing depend on the opioid used, withdrawal symptoms, medical history, and previous treatment. Buprenorphine, methadone, and naltrexone are FDA-approved medications for opioid use disorder.
Buprenorphine can reduce opioid withdrawal and cravings, while methadone is a long-acting medication used to treat opioid use disorder. Naltrexone blocks opioid receptors and requires an opioid-free period before starting treatment. These medications may be combined with counseling and other addiction recovery services.
Naloxone can reverse an overdose involving fentanyl, heroin, or prescription opioids by blocking opioid effects and restoring breathing, and it is available over the counter in several countries. Families should know how to recognize an overdose, where naloxone is stored, how to administer common community formulations such as intranasal naloxone, and when to call 911. A safety plan can also address reduced tolerance, high-risk drug combinations, medication storage, and emergency steps.
Counseling and behavioral therapy can address cravings, substance use triggers, coping skills, mental health symptoms, and behaviors connected to opioid use. Therapy can also help patients develop relapse prevention strategies and strengthen their recovery support system. These services may be used alongside medications for opioid use disorder.
The period after a nonfatal overdose provides an important opportunity to connect a person with addiction treatment. Rapid follow-up can include an opioid use disorder assessment, MAT evaluation, naloxone, counseling, and continued monitoring. Starting and staying engaged in evidence-based treatment can reduce the risk of another overdose and support recovery.
Opioid overdose remains a major public health concern in Tennessee and across the United States. In the United States, opioid overdose deaths exceeded 74,000 in 2021. Fentanyl is involved in many opioid overdose deaths because of its high potency and presence in the illicit drug supply, underscoring the national burden of the opioid epidemic. Tennessee has reported recent declines in fentanyl-related overdose deaths, but fatal and nonfatal opioid overdoses remain an ongoing concern.
Research from the National Institute, Mental Health Services Administration, and Centers for Disease Control and Prevention helps guide responses to drug abuse and overdose among people taking opioids. Studies, including randomized trials and Morbidity and Mortality Weekly Report data, examine rapid-onset drug naloxone, IV administration, and overdose outcomes, while the World Drug Report tracks broader opioid trends.
Opioid use disorder can occur with mental health conditions such as major depressive disorder, generalized anxiety disorder, panic disorder, post-traumatic stress disorder (PTSD), bipolar disorder, and other mood or anxiety disorders. Symptoms may include persistent sadness, hopelessness, panic attacks, excessive worry, sleep problems, traumatic memories, mood changes, or difficulty functioning. These conditions can affect substance use, treatment participation, and the risk of returning to opioids.
Suicidal thoughts or behaviors are also an important concern, especially when opioid addiction occurs with depression, trauma, severe emotional distress, or previous suicide attempts. Mental health screening after an overdose can identify conditions that may require psychiatric care, therapy, medication management, or a higher level of treatment.
People with opioid use disorder may also use alcohol, cannabis, cocaine, methamphetamine, nicotine, or prescription medications. Benzodiazepines such as alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonopin) are especially concerning when combined with opioids because both can suppress the central nervous system. Alcohol can create a similar risk when used with fentanyl, heroin, oxycodone, hydrocodone, or other opioids.
Cocaine and methamphetamine can also appear in polysubstance use patterns, and illicit stimulants may be contaminated with fentanyl. Treatment should assess all substances being used rather than focusing only on opioids.
Relapse prevention focuses on identifying cravings, stress, people, places, and situations connected to opioid use. Long-term recovery may include medication, counseling, peer support, family involvement, and regular follow-up care. Keeping naloxone available and understanding the overdose risk caused by reduced tolerance are also important.
Common barriers include withdrawal, cravings, stigma, transportation problems, treatment costs, lack of insurance, unstable housing, and limited access to care. Depression, anxiety, trauma, and fear of withdrawal can also delay treatment. Rapid referrals, medication access, and flexible treatment options can help reduce these barriers.
Emergency treatment focuses on restoring breathing with basic life support, airway support, and naloxone. Emergency teams may use nasal, IM, SC, or IV naloxone, with multiple doses or an IV naloxone infusion when needed. Naloxone hydrochloride is the standard opioid antagonist for rapid overdose reversal, while nalmefene has a longer half-life; higher-dose naloxone products were FDA-approved in 2021, and wearable naloxone devices and the CSX-1004 monoclonal antibody are being studied.
Immediate medical care remains important because pulmonary edema, abdominal pain, or recurrent respiratory depression may require hospital treatment. Emergency services and first responders may administer naloxone using a nasal spray, IM naloxone, or SC naloxone, with different naloxone doses and higher-dose formulations available for overdose reversal in clinical and hospital settings. Generic naloxone supports rapid naloxone reversal and may be administered by emergency medical services or in a clinical setting, including for patients receiving opioids in palliative care.
The appropriate level of care depends on opioid use severity, overdose history, withdrawal risk, mental health symptoms, and safety needs. Residential treatment provides structured living support, while PHP and IOP provide intensive treatment without overnight care. Outpatient treatment provides scheduled addiction services with greater independence.
Families can support recovery by learning about opioid use disorder, keeping naloxone available, recognizing overdose signs, and encouraging continued treatment. Family therapy or education can also improve communication, establish healthy boundaries, and help relatives recognize relapse or overdose warning signs.
Professional treatment should be considered after any opioid overdose, especially when opioid use continues or the person cannot stop without help. Call 911 for a suspected overdose, loss of consciousness, severe breathing problems, or another medical emergency. Immediate crisis help is also important for suicidal thoughts, suicide attempts, or threats of serious harm.
Provides medical support for opioid withdrawal and related health concerns.
Provides structured living with addiction and mental health care.
Partial Hospitalization Program (PHP) provides intensive daytime treatment without overnight care.
Provides frequent structured treatment with greater independence.
Outpatient Treatment provides scheduled counseling, medication management, and recovery support.
Uses buprenorphine, methadone, or naltrexone to treat opioid use disorder.
Dual-Diagnosis Treatment addresses opioid addiction and conditions such as depression, anxiety, PTSD, or bipolar disorder.
Addresses triggers, cravings, coping skills, and relapse prevention.
Provides education, safety planning, boundaries, and recovery support.
Health insurance may cover opioid addiction treatment when it is medically necessary and included in the plan. Benefits may include detox, residential treatment, PHP, IOP, outpatient care, therapy, mental health services, and medications. Coverage, copays, deductibles, provider networks, and prior authorization requirements vary by plan.
Treatment after opioid overdose can address more than the immediate effects of drug overdose or opioid toxicity. After receiving naloxone and emergency medical care, continued addiction treatment may address substance abuse, illicit opioids, other substances, mental health needs, and the risk of another fentanyl overdose.
Medication-assisted treatment, counseling, support groups, naloxone access, and family safety planning can support continued recovery and reduce future overdose risk.
At New Hope Healthcare, as an in-network provider we work with most insurance plans, such as:
If you or a loved one are struggling with mental health challenges or substance abuse, seeking treatment and emotional support is crucial.
Consulting a doctor can provide the necessary support and guidance for your teen. Reach out to New Hope Healthcare today. Our team of compassionate professionals is here to support your journey towards lasting well-being.
Effective medication management is a crucial part of the treatment process to ensure safety and success.
Give us a call at 866-799-0806.
Treatment may include medical evaluation, medication-assisted treatment (MAT), counseling, naloxone access, and ongoing addiction care.
Yes. A medical provider can evaluate whether medications such as buprenorphine, methadone, or naltrexone are appropriate.
Naloxone can rapidly reverse an opioid overdose and should remain available because another overdose can occur.
Medical monitoring and follow-up care can identify complications, opioid use disorder, and the need for continued treatment.
Yes. Naloxone can wear off while opioids remain active, so emergency medical evaluation is still important.
Follow-up and addiction treatment should begin as quickly as possible after the person is medically stable.
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